People don’t take their pills like they’re supposed to. The doctor writes the prescription, the patients fill it at the drugstore—but they don’t pick up the refill or never fill it in the first place.

It’s a huge problem for the health care economy. People with chronic diseases like asthma, diabetes or bipolar disorder aren’t stabilizing their condition, leading to extra doctor visits or even trips to the emergency room and preventable hospitalizations.

It’s another kind of problem for the pharmaceutical industry, which estimates it experienced $188 billion in lost sales in 2011 in the U.S. alone and $564 billion globally. And unfilled prescriptions represent a major loss of potential revenue for chains like Walgreens.

Today the Deerfield-based drugstore chain announced an agreement with HealthPrize Technologies to offer a digital patient engagement product for Walgreens customers. Patients who sign up for the program will get weekly condition-related quizzes, surveys, daily health tips, contests and incentive prizes, all to help remind them of the importance of taking their prescriptions on time and correctly.

GAMIFICATION

“We give people a rich, gamified user experience, using concepts from behavioral economics and consumer marketing to make patients smarter,” said Tom Kottler, CEO and co-founder of HealthPrize.

The digital platform will be offered through the Walgreens website and mobile apps. The first product, oriented to diabetics, will go live early in the fall, to be followed by games and quizzes for patients with high cholesterol, depression, lung disease and gastrointestinal troubles.

Walgreens has been offering digital tools for several years to remind patients to get refills, take their pills or check their glucose, said Greg Orr, senior director of digital health at the chain. Those were mostly oriented toward encouraging transactions.

The question now is “can we build an experience, not to just take medications but educate them, engage with them on the other things they can do for their disease?” Orr said. “Like, when are the best times to do things, when to do foot exams or eye exams with a physician?” Maybe this will help patients take better control of their health status, he said.

A COSTLY PROBLEM

Medical nonadherence was estimated to cause $290 billion in otherwise avoidable costs to the U.S. health care system, according to a 2009 report by the New England Healthcare Institute, a research center funded by the pharmaceutical and insurance industries.

The figure is “credible,” said Paul Ginsburg, a health economist at the Brookings Institution and the Leonard Schaeffer Center at the University of Southern California.

“Whether the Walgreens initiative is going to be successful depends on the reasoning behind nonadherence,” Ginsburg added. “They assume that people are forgetful and that reminders and modest incentives will make them be less forgetful. I am sure part of nonadherence is because people cannot afford the drug. In that case, this is not going to be helpful.”

Orr said that the HealthPrize game won’t address that issue but that Walgreens works closely with drug makers to promote coupons for co-pays and other discounts for consumers.